Acute and 3-month effects of calcium carbonate on the calcification propensity of serum and regulators of vascular calcification: secondary analysis of a randomized controlled trial

SUMMARY

Calcium supplements have been associated with increased cardiovascular risk, but the mechanism is unknown. We investigated the effects of calcium supplements on the propensity of serum to calcify, based on the transition time of primary to secondary calciprotein particles (T50). Changes in serum calcium were related to changes in T50.

INTRODUCTION

Calcium supplements have been associated with increased cardiovascular risk; however, it is unknown whether this is related to an increase in vascular calcification.

METHODS

We investigated the acute and 3-month effects of calcium supplements on the propensity of serum to calcify, based on the transition time of primary to secondary calciprotein particles (T50), and on three possible regulators of calcification: fetuin-A, pyrophosphate and fibroblast growth factor-23 (FGF23). We randomized 41 postmenopausal women to 1 g/day of calcium as carbonate, or to a placebo containing no calcium. Measurements were performed at baseline and then 4 and 8 h after their first dose, and after 3 months of supplementation. Fetuin-A, pyrophosphate and FGF23 were measured in the first 10 participants allocated to calcium carbonate and placebo who completed the study.

RESULTS

T50 declined in both groups, the changes tending to be greater in the calcium group. Pyrophosphate declined from baseline in the placebo group at 4 h and was different from the calcium group at this time point (p = 0.04). There were no other significant between-groups differences. The changes in serum total calcium from baseline were significantly related to changes in T50 at 4 h (r = -0.32, p = 0.05) and 8 h (r = -0.39, p = 0.01), to fetuin-A at 3 months (r = 0.57, p = 0.01) and to pyrophosphate at 4 h (r = 0.61, p = 0.02).

CONCLUSIONS

These correlative findings suggest that serum calcium concentrations modulate the propensity of serum to calcify (T50), and possibly produce counter-regulatory changes in pyrophosphate and fetuin-A. This provides a possible mechanism by which calcium supplements might influence vascular calcification.

Upregulation of alkaline phosphatase and pyrophosphate hydrolysis: potential mechanism for uremic vascular calcification

Pyrophosphate is a potent inhibitor of medial vascular calcification where its level is controlled by hydrolysis via a tissue-nonspecific alkaline phosphatase (TNAP). We sought to determine if increased TNAP activity could explain the pyrophosphate deficiency and vascular calcification seen in renal failure. TNAP activity increased twofold in intact aortas and in aortic homogenates from rats made uremic by feeding adenine or by 5/6 nephrectomy. Immunoblotting showed an increase in protein abundance but there was no increase in TNAP mRNA assessed by quantitative polymerase chain reaction. Hydrolysis of pyrophosphate by rat aortic rings was inhibited about half by the nonspecific alkaline phosphatase inhibitor levamisole and was reduced about half in aortas from mice lacking TNAP. Hydrolysis was increased in aortic rings from uremic rats and all of this increase was inhibited by levamisole. An increase in TNAP activity and pyrophosphate hydrolysis also occurred when aortic rings from normal rats were incubated with uremic rat plasma. These results suggest that a circulating factor causes pyrophosphate deficiency by regulating TNAP activity and that vascular calcification in renal failure may result from the action of this factor. If proven by future studies, this mechanism will identify alkaline phosphatase as a potential therapeutic target.

The fallacy of the calcium-phosphorus product

Scattered through the practice of medicine are dogmas with little or no scientific basis. One of these is the product of the serum calcium and phosphorus concentrations, the so-called calcium-phosphorus product or Ca x P. The assumption that ectopic calcification will occur when the product of the serum calcium and phosphorus concentrations exceeds a particular threshold has become standard practice in nephrology even though there is little scientific basis. Experimental support is lacking, the chemistry underlying the use of the product is oversimplified and the concept that ectopic calcification is simply the result of supersaturation is biologically flawed. The evidence that the Ca x P is an independent risk factor for mortality and morbidity is also questionable. Although ectopic calcification can occur in many sites, this review will focus on vascular calcification, as it is the most common site and the site most likely to affect patient outcomes.

Vascular calcification: not so crystal clear

Patients with renal failure are predisposed to calcification of the medial layer of arteries. This calcification is far more complex than simple precipitation of calcium and phosphate and involves multiple forms of calcium phosphate. Like bone, calcification in the vessels also involves biologic events. The two are necessarily linked and unraveling the pathophysiology will require an understanding of both.

Chemical and hormonal determinants of vascular calcification in vitro

Vascular calcification is a complex process that is dependent not only on the physicochemical effects of Ca, PO(4), and pH, but also on smooth muscle factors that may be regulated by these ions as well as by 1,25-dihydroxyvitamin D(3) (calcitriol) and parathyroid hormone (PTH). These minerals and hormones were tested in a model of medial calcification in rat aorta maintained in culture for 9 days. Calcification was quantitated as incorporation of (45)Ca, alkaline phosphatase activity was measured in aortic homogenates, and osteopontin production was measured from immunoblots of culture medium. At 1.8 mM Ca (1.46 mM free), calcification occurred at or above 2.8 mM PO(4). At 3.8 mM PO(4), calcification occurred at or above 1.10 mM free [Ca]. At a constant [Ca] x [PO(4)], calcification varied directly with [Ca] and inversely with [PO(4)]. Calcification was directly related to pH between 7.19 and 7.50 but not altered by PTH or calcitriol. Alkaline phosphatase activity and osteopontin production were increased by Ca, PO(4), calcitriol, and PTH. We conclude that calcification of rat aorta in vitro requires elevation of both [Ca] and [PO(4)], and that [Ca] rather than [PO(4)] or the product of the two is the dominant determinant. The induction of alkaline phosphatase and osteopontin indicates that Ca and PO(4) have effects in addition to simple physicochemical actions. Although PTH and calcitriol did not increase calcification in vivo, they have effects on smooth muscle that could influence calcification in vivo. Calcification is enhanced by alkalinity within the range produced during hemodialysis.

Growth factors stimulate the Na-K-2Cl cotransporter NKCC1 through a novel Cl(-)-dependent mechanism

The Na-K-2Cl cotransporter NKCC1 is an important volume-regulatory transporter that is regulated by cell volume and intracellular Cl(-). This regulation appears to be mediated by phosphorylation of NKCC1, although there is evidence for additional, cytoskeletal regulation via myosin light chain (MLC) kinase. NKCC1 is also activated by growth factors and may contribute to cell hypertrophy, but the mechanism is unknown. In aortic endothelial cells, NKCC1 (measured as bumetanide-sensitive (86)Rb(+) influx) was rapidly stimulated by serum, lysophosphatidic acid, and fibroblast growth factor, with the greatest stimulation by serum. Serum increased bumetanide-sensitive influx significantly more than bumetanide-sensitive efflux (131% vs. 44%), indicating asymmetric stimulation of NKCC1, and produced a 17% increase in cell volume and a 25% increase in Cl(-) content over 15 min. Stimulation by serum and hypertonic shrinkage were additive, and serum did not increase phosphorylation of NKCC1 or MLC, and did not decrease cellular Cl(-) content. When cellular Cl(-) was replaced with methanesulfonate, influx via NKCC1 increased and was no longer stimulated by serum, whereas stimulation by hypertonic shrinkage still occurred. Based on these results, we propose a novel mechanism whereby serum activates NKCC1 by reducing its sensitivity to inhibition by intracellular Cl(-). This resetting of the Cl(-) set point of the transporter enables the cotransporter to produce a hypertrophic volume increase.

Contractile regulation of the Na(+)-K(+)-2Cl(-) cotransporter in vascular smooth muscle

Vasoconstrictors activate the Na(+)-K(+)-2Cl(-) cotransporter NKCC1 in rat aortic smooth muscle, but the mechanism is unknown. Efflux of (86)Rb(+) from rat aorta in response to phenylephrine (PE) was measured in the absence and presence of bumetanide, a specific inhibitor of NKCC1. Removal of extracellular Ca(2+) completely abolished the activation of NKCC1 by PE. This was not due to inhibition of Ca(2+)-dependent K(+) channels since blocking these channels with Ba(2+) in Ca(2+)-replete solution did not prevent activation of NKCC1 by PE. Stimulation of NKCC1 by PE was inhibited 70% by 75 microM ML-9, 97% by 2 microM wortmannin, and 70% by 2 mM 2,3-butanedione monoxime, each of which inhibited isometric force generation in aortic rings. Bumetanide-insensitive Rb(+) efflux, an indication of Ca(2+)-dependent K(+) channel activity, was reduced by ML-9 but not by the other inhibitors. Stretching of aortic rings on tubing to increase lumen diameter to 120% of normal almost completely blocked the stimulation of NKCC1 by PE without inhibiting the stimulation by hypertonic shrinkage. We conclude that activation of the Na(+)-K(+)-2Cl(-) cotransporter by PE is the direct result of smooth muscle contraction through Ca(2+)-dependent activation of myosin light chain kinase. This indicates that the Na(+)-K(+)-2Cl(-) cotransporter is regulated by the contractile state of vascular smooth muscle.

How echogenic is echogenic? Quantitative acoustics of the renal cortex

The echogenicity of the cortex is an important parameter in interpreting renal sonograms that suggest changes in cortical structure. Echogenicity is currently measured qualitatively, and no attempts have been made at quantification. We developed a method to quantify renal cortical echogenicity in reference to the liver and evaluated its reproducibility, dependence on scanning variables, and potential utility. Sonograms of the right kidney were digitized, and the mean pixel density of regions of the renal cortex and liver was measured and normalized to the gray scale. Echogenicity was expressed as the ratio of the brightness (inverse of mean pixel density) of the cortex to that of the liver. The mean coefficient of variation among measurements performed on multiple sonograms from the same study was 2.8%, and the coefficient of variation among multiple measurements performed on the same kidney over 1 year was 1.8%. The correlation between measurements obtained by two different individuals on identical images was 0.92, with a mean variation of 3.0%. Echogenicity was not significantly affected by type of scanner or probe frequency, but varied inversely with gain. However, the effect of gain was very small within the useful range. Water loading after an overnight fast increased echogenicity in all cases, with a mean increase of 6.4%. Echogenicity of normal kidneys was significantly less than that of the liver (range, 0.810 to 0.987), and in clinical sonograms analyzed retrospectively but blindly, echogenicity correlated with the qualitative gradations of echogenicity originally assigned. The most echogenic kidneys were 62% brighter than normal kidneys, many times greater than the variability of the measurement. We conclude that quantification of renal cortical echogenicity is feasible and reproducible and may be useful in detecting and following renal disease. Echogenicity of the renal cortex is less than that of the liver in healthy subjects and is influenced by the state of diuresis.

Sonographic evaluation of renal failure

Sonography is a critical component of the evaluation of both acute and chronic renal failure; however, most nephrologists have a limited knowledge of this procedure. The acoustic properties, limited spectrum of pathological changes, and ease of visualization of the kidneys, coupled with the safety, simplicity, and low cost of sonography, make it the modality of choice for renal imaging. This review discusses the basics of sonography as they apply to the kidney and describes the findings encountered in the more common causes of renal failure. Although many sonographic findings are nonspecific, their diagnostic use is greatly enhanced by a familiarity with the clinical presentation and a thorough understanding of renal pathophysiological characteristics. Therefore, nephrologists should be knowledgeable about renal sonography and participate in its interpretation.

Bedside renal biopsy: ultrasound guidance by the nephrologist

The safety and efficacy of percutaneous biopsy of native kidneys performed entirely by nephrologists at the patient's bedside was evaluated in 101 consecutive patients. The location and depth of the kidney were determined with a portable ultrasound machine, and biopsy was performed with a 15G, automatic, spring-loaded biopsy device without direct ultrasonographic guidance. Renal tissue was obtained in 99 patients, and all samples were adequate for diagnosis, with an average of 33 glomeruli and more than 10 glomeruli in 97%. The number of biopsy attempts was four or fewer in 80% of patients. Three patients developed symptomatic bleeding, all of whom had a risk factor for bleeding, but none required procedures to control the bleeding. Asymptomatic hematuria occurred in two other patients. Overall, the mean decrease in hematocrit was 1.5, with a decrease of 5.0 or greater in six patients. The results are similar to those of previous studies using automatic devices but under direct ultrasound guidance. A subset of 20 patients with abnormal platelet counts, coagulation times, or bleeding times accounted for four of the five patients with complications. We conclude that percutaneous biopsy of native kidneys can be adequately and safely performed in its entirety by nephrologists at the patient's bedside. Furthermore, excellent results can be obtained without direct sonographic guidance. Hemorrhage occurs almost exclusively in those patients with abnormal platelet counts, coagulation times, or bleeding times.

JNK is a volume-sensitive kinase that phosphorylates the Na-K-2Cl cotransporter in vitro

Cell shrinkage phosphorylates and activates the Na-K-2Cl cotransporter (NKCC1), indicating the presence of a volume-sensitive protein kinase. To identify this kinase, extracts of normal and shrunken aortic endothelial cells were screened for phosphorylation of NKCC1 fusion proteins in an in-the-gel kinase assay. Hypertonic shrinkage activated a 46-kDa kinase that phosphorylated an NH2-terminal fusion protein, with weaker phosphorylation of a COOH-terminal fusion protein. This cytosolic kinase was activated by both hypertonic and isosmotic shrinkage, indicating regulation by cell volume rather than osmolarity. Subsequent studies identified this kinase as c-Jun NH2-terminal kinase (JNK). Immunoblotting revealed increased JNK activity in shrunken cells; there was volume-sensitive phosphorylation of NH2-terminal c-Jun fusion protein; immunoprecipitation of JNK from shrunken cells but not normal cells phosphorylated NKCC1 in gel kinase assays; and treatment of cells with tumor necrosis factor, a known activator of JNK, mimicked the effect of hypertonicity. We conclude that JNK is a volume-sensitive kinase in endothelial cells that phosphorylates NKCC1 in vitro. This is the first demonstration of a volume-sensitive protein kinase capable of phosphorylating a volume-regulatory transporter.

Vasoconstrictors and nitrovasodilators reciprocally regulate the Na+-K+-2Cl- cotransporter in rat aorta

Little is known about the function and regulation of the Na+-K+-2Cl- cotransporter NKCC1 in vascular smooth muscle. The activity of NKCC1 was measured as the bumetanide-sensitive efflux of 86Rb+ from intact smooth muscle of the rat aorta. Hypertonic shrinkage (440 mosmol/kgH2O) rapidly doubled cotransporter activity, consistent with its volume-regulatory function. NKCC1 was also acutely activated by the vasoconstrictors ANG II (52%), phenylephrine (50%), endothelin (53%), and 30 mM KCl (54%). Both nitric oxide and nitroprusside inhibited basal NKCC1 activity (39 and 34%, respectively), and nitroprusside completely reversed the stimulation by phenylephrine. The phosphorylation of NKCC1 was increased by hypertonic shrinkage, phenylephrine, and KCl and was reduced by nitroprusside. The inhibition of NKCC1 significantly reduced the contraction of rat aorta induced by phenylephrine (63% at 10 nM, 26% at 30 nM) but not by KCl. We conclude that the Na+-K+-2Cl- cotransporter in vascular smooth muscle is reciprocally regulated by vasoconstrictors and nitrovasodilators and contributes to smooth muscle contraction, indicating that alterations in NKCC1 could influence vascular smooth muscle tone in vivo.

Physiological significance of volume-regulatory transporters

Research over the past 25 years has identified specific ion transporters and channels that are activated by acute changes in cell volume and that serve to restore steady-state volume. The mechanism by which cells sense changes in cell volume and activate the appropriate transporters remains a mystery, but recent studies are providing important clues. A curious aspect of volume regulation in mammalian cells is that it is often absent or incomplete in anisosmotic media, whereas complete volume regulation is observed with isosmotic shrinkage and swelling. The basis for this may lie in an important role of intracellular Cl- in controlling volume-regulatory transporters. This is physiologically relevant, since the principal threat to cell volume in vivo is not changes in extracellular osmolarity but rather changes in the cellular content of osmotically active molecules. Volume-regulatory transporters are also closely linked to cell growth and metabolism, producing requisite changes in cell volume that may also signal subsequent growth and metabolic events. Thus, despite the relatively constant osmolarity in mammals, volume-regulatory transporters have important roles in mammalian physiology.

A volume-sensitive, IP3-insensitive Ca2+ store in vascular endothelial cells

The mechanism by which cell swelling and other physical forces increase the intracellular Ca2+ concentration ([Ca2+]i) is poorly defined. In vascular endothelial cells, the increase in [Ca2+]i after hypotonic swelling was independent of external Ca2+ and membrane potential, was not blocked by La3+ or Gd3+, and was prevented by thapsigargin, indicative of intracellular release. This release also occurred after depletion of agonist-sensitive Ca2+ stores. In cells in which the plasma membrane was permeabilized with saponin, hypotonic medium stimulated release of 45Ca2+ from a thapsigargin-sensitive site. Isosmotic substitutions with sucrose or urea revealed that this release was due specifically to swelling and not to changes in osmolarity or ion concentrations. This volume-sensitive release was inhibited by high concentrations of La3+ and Gd3+ in a time-dependent manner, suggesting inhibition from within the storage compartment. Release was not inhibited by ruthenium red or by prior stimulation with inositol 1,4,5-trisphosphate (IP3), indicating that the volume-sensitive storage site is distinct from mitochondria and from stores sensitive to ryanodine or IP3. The results suggest the presence of a novel, stretch-activated Ca2+ store in endothelial cells that could contribute to their mechanosensitivity.

Shrinkage-induced activation of Na+/H+ exchange: role of cell density and myosin light chain phosphorylation

Previously, we suggested that myosin light chain kinase (MLCK) is involved in shrinkage-induced activation of the Na+/H+ exchanger in rat astrocytes. Here we have studied the effects of hyperosmotic exposure in C6 glioma cells, a common model for astrocytes. Shrinkage-induced activation of the Na+/H+ exchanger in C6 cells is directly proportional to the degree of shrinkage, results in an alkaline shift in the pK' of the exchanger, is dependent on ATP, and is inhibited by ML-7 (an MLCK inhibitor) and by various calmodulin inhibitors. Cell shrinkage also results in increased phosphorylation of myosin light chain (MLC). Interestingly, shrinkage-induced activation of the exchanger does not occur in subconfluent C6 cells. However, phosphorylation of MLC still occurs in subconfluent cultures of C6 cells on shrinkage, suggesting that the lack of activation in these cells occurs at a point between MLC phosphorylation and Na+/H+ exchange activation. The lack of activation of Na+/H+ exchange in subconfluent C6 cells can be utilized to further elucidate the shrinkage-induced activation pathway.

Volume-sensitive myosin phosphorylation in vascular endothelial cells: correlation with Na-K-2Cl cotransport

To identify protein kinases that are regulated by cell volume, we examined protein phosphorylation in hypertonically shrunken aortic endothelial cells. Shrinkage reversibly increased, and swelling decreased, phosphorylation of a 19-kDa cytoskeletal protein identified as myosin light chain (MLC) by immune precipitation and immunoblotting. Shrinkage also increased MLC phosphorylation in human umbilical vein endothelial cells, rat aortic smooth muscle cells, and human dermal fibroblasts. Phosphorylation was blocked by ML-7, an inhibitor of MLC kinase (MLCK). Neither inhibition of protein kinase C nor inhibition of myosin phosphatase (with calyculin) altered MLC phosphorylation. Peptide mapping of MLC indicated phosphorylation by MLCK. Na-K-2Cl cotransport activation paralleled MLC phosphorylation in hypertonic medium. Na-K-2Cl was stimulated by low concentrations of ML-7 with no further stimulation by hypertonic shrinkage and was inhibited by higher concentrations, paralleling inhibition of MLC phosphorylation. Shrinkage-induced phosphorylation of the cotransporter was not blocked by ML-7. We conclude that cell volume regulates MLC phosphorylation by MLCK. MLCK influences Na-K-2Cl cotransport but independently of cotransporter phosphorylation. These data suggest an important link between cell volume, volume-regulatory transporters, and the contractile state of the cytoskeleton.

Flow-mediated NO release from endothelial cells is independent of K+ channel activation or intracellular Ca2+

The role of K+ channels and intracellular [Ca2+] in flow-induced nitric oxide (NO) production was investigated in bovine aortic endothelial cells in culture. NO release (measured as nitrite production) and K+ channel activity (measured as 86Rb+ efflux) were measured in cells grown on collagen-coated microcarrier beads and perfused in a column. An eightfold increase in flow produced a rapid (within 1 min), sustained, and reversible sixfold increase in NO release. Efflux of 86Rb+ also increased but rapidly returned to baseline and then transiently decreased when flow was decreased. This was probably due to boundary layer washout rather than to K+ channel activation, because an identical pattern was seen for release of [3H]ouabain. Neither tetraethylammonium nor increasing medium [K+] to block K+ currents prevented flow-induced NO release. Removal of medium Ca2+ or chelation of intracellular Ca2+ also did not block flow-mediated NO release. The results demonstrate that flow rapidly increases NO release from endothelial cells but that this increase in NO release is not dependent on activation of K+ channels or changes in intracellular [Ca2+].

Shrinkage-induced activation of Na+/H+ exchange in primary rat astrocytes: role of myosin light-chain kinase

Primary rat astrocytes exposed to hyperosmotic solutions undergo Na(+)-dependent amiloride-sensitive alkalinization of 0.36 U [measured with the pH-sensitive fluorescent dye 2',7'-bis(carboxyethyl)-5(6)-carboxy-fluorescein], suggesting that shrinkage-induced alkalinization is due to activation of Na+/H+ exchange (NHE). Alkalinization is maintained for at least 20 min, and is readily reversible and ATP dependent. Hyperosmotic solutions produced no increase of intracellular Ca2+ or adenosine 3',5'-cyclic monophosphate (cAMP). Loading cells with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid, a Ca2+ chelator, or depleting cells of protein kinase C (PKC) had no effect on activation of NHE. Thus shrinkage-induced activation of NHE does not involve cAMP, Ca2+, or PKC. However, ML-7, an inhibitor of myosin light-chain kinase (MLCK), inhibited shrinkage-induced activation with a half-maximal inhibition of 56 microM. This activation was also inhibited by 500 microM N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide, 100 microM chlorpromazine, and 50 microM trifluoperazine, all calmodulin inhibitors. Shrinkage increased the phosphorylation of an 18-kDa protein that colocalizes with myosin light chain. Our data suggest that shrinkage-induced activation of NHE in astrocytes occurs via a novel pathway involving activation of calmodulin-dependent MLCK and phosphorylation of myosin light chain.

Functional coupling of Na(+)-K(+)-2Cl- cotransport and Ca(2+)-dependent K+ channels in vascular endothelial cells

To determine whether the activation of Na(+)-K(+)-2Cl- cotransport by Ca(2+)-mobilizing agonists is a direct effect of Ca2+ or is secondary to activation of Ca(2+)-dependent K+ channels [via cell shrinkage or decreased intracellular Cl- concentration ([Cl-]), we measured K+ fluxes in aortic endothelial cells in response to ATP and bradykinin. With either agonist there was an immediate bumetanide-insensitive efflux inhibitable by the K+ channel blockers tetrabutylammonium (TBA, 23 mM) and quinidine (1 mM), followed several minutes later by increased bumetanide-sensitive efflux or influx (Na(+)-K(+)-2Cl- cotransport). ATP induced a loss of cell K+ that was prevented by TBA and augmented by bumetanide. Both TBA and quinidine prevented the stimulation of cotransport by agonists but not by hypertonic shrinkage. Raising medium [K+] to prevent K+ loss also blocked activation of cotransport by agonists. The results indicate that the stimulation of Na(+)-K(+)-2Cl- cotransport by Ca2+ is not direct but instead is indirect via activation of Ca(2+)-dependent K+ channels and a resulting decrease in cell volume and intracellular [Cl-]. This suggests that at least one role of Na(+)-K(+)-2Cl- cotransport in endothelial cells is to maintain cell volume and intracellular [Cl-] during agonist stimulation.

Impaired cation transport in thymocytes of rats with chronic uremia includes the Na+/H+ antiporter

To examine how uremia changes sodium, potassium, and proton transport, thymocytes from chronic renal failure (CRF) rats were studied. If alterations in cation transport associated with chronic uremia (CRF) extend to intracellular pH regulation, the susceptibility to the catabolic effects of acidosis might be increased. To evaluate the influence of acidosis, cation transport in thymocytes from normal rats with NH4Cl-induced acidosis was also studied. Ouabain-sensitive 86Rb influx in thymocytes from acidotic CRF rats was 32% lower than in control cells (P < 0.05), but intracellular sodium concentration was unchanged. This may be related to a 47 +/- 22% reduction in 22Na influx. In thymocytes from nonuremic, acidotic rats, ouabain-sensitive 86Rb influx was decreased 39% (P < 0.025), similar to the change in CRF. In CRF thymocytes, Na(+)-H+ antiporter activity in response to cell acidification (7.13 +/- 0.8 versus 9.42 +/- 0.8 mmol of H+/L per min; CRF versus control), or to osmotic shrinkage (0.43 +/- 0.09 versus 0.82 +/- 0.11 mmol of H+/L per min; CRF versus control), was significantly (P < 0.01) reduced. Buffering capacity at resting and acidic intracellular pH was unchanged by uremia, but Na+/H+ antiporter activity in response to acid loading or osmotic shrinkage was unchanged in thymocytes of nonuremic rats with metabolic acidosis. Thus, CRF reduces both Na/K-ATPase and Na+/H+ antiporter activities in rat thymocytes. The former may be secondary to reduced sodium influx. Impaired Na+/H+ antiporter activity is not caused by metabolic acidosis alone, whereas reduced Na/K-ATPase activity is found in both acidosis and uremia.

Swelling-activated K+ fluxes in vascular endothelial cells: role of intracellular Ca2+

Swelling of bovine aortic endothelial cells activates Ca(2+)-dependent K+ channels. To determine the role of Ca2+ in this response, we examined the effect of cell swelling on intracellular Ca2+ concentration ([Ca2+]i), and the role of [Ca2+]i in swelling-activated K+ efflux. Basal [Ca2+]i, measured by fura 2 fluorescence, was 62 nM and increased by 36 nM in hypotonic medium (220 mosmol/l) compared with a 277 nM increase in response to extracellular ATP. In cells loaded with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetra-acetic acid (BAPTA), the increases induced by swelling and by ATP were reduced to 13 and 20 nM, respectively. Exposure to hypotonic medium (220 mosmol/kg) or to the Ca2+ ionophore A-23187 stimulated a furosemide-insensitive 86Rb efflux consistent with activation of K+ channels. The swelling-activated efflux was inhibited 16% by 5 mM tetraethylammonium and 24% by 23 mM tetrabutylammonium, but not by 100 microM quinidine, a pattern similar to that previously observed for swelling-activated K+ channels in cell-attached patches. The effects of A-23187 and hypotonic swelling on 86Rb efflux were completely additive, suggesting Ca(2+)-independent activation by cell swelling. Removal of Ca2+ from the external medium or loading of cells with BAPTA to buffer intracellular Ca2+ blocked the activation of 86Rb efflux by A-23187, but not by hypotonic swelling. Hypertonic medium (440 mosmol/kg by the addition of sucrose) attenuated the increased 86Rb efflux in response to A-23187. We conclude that the activation of K+ efflux in swollen endothelial cells occurs independently of changes in [Ca2+]i.(ABSTRACT TRUNCATED AT 250 WORDS)

Swelling-activated K fluxes in vascular endothelial cells: volume regulation via K-Cl cotransport and K channels

K efflux pathways responsible for regulatory volume decrease (RVD) were examined in bovine aortic endothelial cells. Hypotonic swelling produced a rapid and reversible threefold increase in bumetanide-insensitive 86Rb efflux. Swelling-activated 86Rb efflux was inhibited 43% when Cl was replaced with NO3, and this Cl-dependent efflux was inhibited by 1 mM furosemide. Neither Cl replacement nor furosemide inhibited the efflux stimulated by a Ca ionophore (A23187) in isotonic medium. Swelling-activated 86Rb efflux was also inhibited by 4,4'-diisothiocyanostilbene-2,2'-disulfonate but not by dinitrostilbenedisulfonate. Cell swelling induced a volume-regulatory K loss that was incomplete in hypotonic medium but complete and more rapid when bumetanide was added or when cells were swollen isosmotically. K loss in the presence of bumetanide was partially blocked by furosemide. We conclude that two separate swelling-activated K fluxes mediate RVD in aortic endothelial cells: a Cl-dependent, furosemide-sensitive, but bumetanide-insensitive flux that is consistent with K-Cl cotransport, and a Cl-independent efflux that presumably is mediated by K channels.

Regulation by cell volume of Na(+)-K(+)-2Cl- cotransport in vascular endothelial cells: role of protein phosphorylation

Na(+)-K(+)-2Cl- cotransport in aortic endothelial cells is activated by cell shrinkage, inhibited by cell swelling, and is responsible for recovery of cell volume. The role of protein phosphorylation in the regulation of cotransport was examined with two inhibitors of protein phosphatases, okadaic acid and calyculin, and a protein kinase inhibitor, K252a. Both phosphatase inhibitors stimulated cotransport in isotonic medium, with calyculin, a more potent inhibitor of protein phosphatase I, being 50-fold more potent. Neither agent stimulated cotransport in hypertonic medium. Stimulation by calyculin was immediate and was complete by 5 min, with no change in cell Na + K content, indicating that the stimulation of cotransport was not secondary to cell shrinkage. The time required for calyculin to activate cotransport was longer in swollen cells than in normal cells, indicating that the phosphorylation step is affected by cell volume. Activation of cotransport when cells in isotonic medium were placed in hypertonic medium was more rapid than the inactivation of cotransport when cells in hypertonic medium were placed in isotonic medium, which is consistent with a shrinkage-activated kinase rather than a shrinkage-inhibited phosphatase. K252a, a nonspecific protein kinase inhibitor, reduced cotransport in both isotonic and hypertonic media. The rate of inactivation was the same in either medium, indicating that dephosphorylation is not regulated by cell volume. These results demonstrate that Na(+)-K(+)-2Cl- cotransport is activated by protein phosphorylation and is inactivated by a Type I protein phosphatase. The regulation of cotransport by volume is due to changes in the rate of phosphorylation rather than dephosphorylation, suggesting the existence of a volume-sensitive protein kinase. Both the kinase and the phosphatase are constitutively active, perhaps to allow for rapid changes in cotransport activity.

Ca(2+)-dependent and Ca(2+)-permeable ion channels in aortic endothelial cells

We investigated whether osmotic stress would activate specific ion channels in bovine aortic endothelial cells (BAECs). In isotonic medium (290 mosmol/kgH2O), cell-attached patch recordings contained both 165-pS K+ channels activated by depolarization and 40-pS K+ channels activated by 200 nM bradykinin. These inwardly rectifying K+ channels were activated by raising "cytoplasmic" Ca2+ in inside-out patches. BAEC exposed to hypotonic bath (220 mosmol/kg) exhibited a 20% decrease in intracellular K+ content within 5 min. Cell-attached patches revealed biphasic K+ channel activation with hypotonic exposure; initial activation of 165- and 40-pS K+ channels (1-3 min) was followed by a delayed but sustained reactivation of both K+ channels (> 5 min). The delayed reactivation phase was dependent on the presence of external Ca2+ and was attenuated by 10 microM gadolinium. A 28-pS nonselective cation channel (NSCC), which conducted inward Ca2+ current, was also detected during hypotonic exposure. This NSCC was stimulated by hyperpolarization and was blocked by 10 microM gadolinium. In BAEC 1) hypotonic exposure activates Ca(2+)-dependent, 165- and 40-pS K+ channels biphasically; 2) the initial phase is independent of external Ca2+, while the delayed phase requires external Ca2+; and 3) Ca(2+)-permeable, 28-pS NSCCs stimulated by membrane hyperpolarization provide a pathway for external Ca2+ influx.

Regulation of vascular endothelial cell volume by Na-K-2Cl cotransport

The relationship between cell volume and Na-K-2Cl cotransport was studied in cultured bovine aortic endothelial cells. Hypertonic cell shrinkage increased bumetanide-sensitive, Na- or Cl-dependent K influx without altering bumetanide-insensitive influx. Greater stimulation of cotransport was observed in cells shrunken isosmotically either by preincubation in K-free and Na-free medium or by preincubation in hypotonic medium. Cell swelling, produced by preincubation in isotonic high-K medium, inhibited bumetanide-sensitive K influx. Simultaneous measurements of [3H]bumetanide binding and K influx revealed an increased number of binding sites without an increased influx per binding site in shrunken cells. Bumetanide did not alter the volume or ion content of cells in isotonic or hypertonic medium, indicating that no net influx of ions occurs through cotransport under these conditions. In isosmotically shrunken cells, there was greater stimulation of bumetanide-sensitive influx than of bumetanide-sensitive efflux, resulting in net bumetanide-sensitive influx. Rapid recovery of cell K, Na, and water occurred over 10-20 min and was inhibited by bumetanide or by the removal of external Na or Cl. These data demonstrate that Na-K-2Cl cotransport in aortic endothelial cells is regulated by cell volume, possibly through changes in the number of functional cotransporters, and mediates a brisk regulatory volume increase in isosmotically shrunken cells. Although thermodynamically favored, no net influx occurs through Na-K-2Cl cotransport in cells of normal volume or in hypertonically shrunken cells. This suggests additional regulation of cotransport, perhaps through trans-inhibition by intracellular Cl. Regulation of cell volume by Na-K-2Cl cotransport may be important in maintaining endothelial integrity.

Swelling-activated K-Cl cotransport: metabolic dependence and inhibition by vanadate and fluoride

Activation of K-Cl cotransport by cell swelling was studied by measuring K influx in isotonic and hypotonic media in human red blood cells after depletion of cellular ATP and after exposure to vanadate or fluoride. Preincubation of red blood cells with 2-deoxyglucose resulted in an inhibition of swelling-activated K-Cl cotransport that paralleled the decline in cellular ATP. Subsequent repletion of ATP by incubation in glucose, phosphate, and guanosine partially restored swelling-activated K-Cl cotransport. Swelling-activated K-Cl cotransport was also inhibited by 200 microM vanadate. This inhibition was partially blocked by DIDS, indicating an intracellular action, and required a 40-min preincubation, suggesting that inhibition was due to vanadyl rather than vanadate. Activation of K-Cl cotransport in swollen cells was also blocked by 16 mM fluoride, an effect that was immediate and independent of Cl concentration. Incubation of cells with 1 mM adenosine 3',5'-cyclic monophosphate (cAMP) to raise intracellular cAMP levels did not inhibit swelling-activated K-Cl cotransport, indicating that fluoride was not acting through adenyl cyclase. No inhibition of Cl-dependent or bumetanide-sensitive K influx in isotonic medium (Na-K-2Cl cotransport) was observed with ATP depletion, vanadate, fluoride, or cAMP. Activation of K-Cl cotransport by N-ethylmaleimide (NEM) was inhibited by ATP depletion but only partially inhibited by fluoride and not inhibited by vanadate. Fluoride inhibited K-Cl cotransport only when added before NEM treatment. These results suggest that activation of K-Cl cotransport by cell swelling requires ATP and involves a phosphohydrolase or phosphotransferase reaction that is inhibited by vanadyl and fluoride.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of bradykinin on Na-K-2Cl cotransport and bumetanide binding in aortic endothelial cells

Simultaneous measurements of potassium influx and binding of [3H]bumetanide were performed in endothelial cells cultured from bovine aortas to determine how bradykinin regulates Na-K-2Cl cotransport. [3H]Bumetanide displayed saturable binding and was displaced by low concentrations of unlabeled bumetanide. All three transported ions were required for binding and high concentrations of chloride inhibited binding, consistent with binding of bumetanide to the second chloride site of the transporter. Scatchard analysis of binding under maximal conditions (100 mM sodium, 30 mM potassium, 30 mM chloride) revealed a single class of binding sites with a binding constant of 112 nM and a density of 22 fmol/cm2 or approximately 122,000 sites/cells. Na-K-2Cl cotransport, measured as bumetanide-sensitive potassium influx, was stimulated 118 +/- 30% by bradykinin (p less than 0.01) at physiologic ion concentrations. Stimulation was inhibited by increased potassium or decreased external chloride concentrations and was not seen in conditions required for maximal binding of bumetanide. Simultaneous measurement of the binding of tracer [3H]bumetanide and its inhibition of potassium influx in medium containing 10 mM potassium and 130 mM chloride revealed a turnover number for the cotransporter of 293 +/- 68 s-1 which increased to 687 +/- 105 s-1 with bradykinin (p less than 0.001). There was no change in cell volume and only a 5.6 mM increase in intracellular sodium concentration associated with this stimulation. Bradykinin also increased the affinity of the cotransporter for bumetanide as indicated by a decrease in the Ki for potassium influx from 464 +/- 46 nM to 219 +/- 19 nM (p less than 0.005). Our results show that [3H]bumetanide can be used to quantitate Na-K-2Cl cotransporter sites in aortic endothelial cells and to determine the mechanism by which cotransport is regulated. The stimulation of cotransport in aortic endothelial cells by bradykinin is due to an increase in the activity of existing transporters rather than to an increase in the number of transporters. This, together with the increased affinity for bumetanide, strongly suggests that a change in cotransporter structure is occurring in response to bradykinin.

Cl-dependent K transport in a pure population of volume-regulating human erythrocytes

Swelling of human red cells activates a putative K-Cl cotransport that is not present at normal cell volume and that disappears after several hours. To determine whether regulatory volume decrease (RVD) is occurring in human erythrocytes and is responsible for the inactivation of K-Cl cotransport, the relationship between cell volume and the inactivation and reactivation of volume-sensitive (VS) K-Cl cotransport was studied. VS K influx into high K cells was transient, whereas influx into low K cells (prepared with nystatin), which are unable to shrink via K efflux, remained fully activated. Likewise, VS K efflux into hypotonic medium disappeared after 100 min in a low K medium but remained activated in a high K medium that prevented cell shrinkage. Cells that had been preincubated in hypotonic medium to inactivate VS K-Cl cotransport showed no significant recovery of VS cotransport after a 6-h incubation in isotonic medium but showed full restoration of VS cotransport after treatment with nystatin in isotonic medium to reequilibrate cell water. A pure fraction of volume-regulating (VR) cells was subsequently isolated by preincubating red cells in hypotonic medium and then subjecting them to further hypotonicity to lyse all non-VR cells. The 2.5% of cells that remained consisted of 16% reticulocytes and exhibited a Cl-dependent RVD in hypotonic medium. VS K-Cl cotransport was enriched 10-fold and Na-K-Cl cotransport was enriched 12-fold in these cells, whereas the enrichment of N-ethylmaleimide (NEM)-activated K-Cl cotransport was only threefold.(ABSTRACT TRUNCATED AT 250 WORDS)

Volume-sensitive, Cl-dependent K transport in resealed human erythrocyte ghosts

Potassium influx and efflux in Cl and NO3 media were measured in resealed ghosts prepared from human red cells. Cl-dependent K influx was three times that in intact cells and, as in intact cells, was partially supported by Br but not by thiocyanate (SCN). In other properties, this flux differed from that in intact cells: substitution of N-methylglucamine for Na did not decrease but rather increased Cl-dependent K influx, the affinity for external K was reduced, with a Km of 21.3 +/- 12.5 mM, and inhibition by furosemide and bumetanide was incomplete. Furosemide at 1 mM inhibited Cl-dependent influx by 26 and 51% at 4 and 20 mM K, respectively. Bumetanide inhibited Cl-dependent K influx by 0 and 55% at concentrations of 10 microM and 1 mM, respectively, in 4 mM K, with no further inhibition at 20 mM K. Neither the magnitude nor the properties of the flux were altered by preparing ghosts in the presence of 1,4-dithiothreitol, indicating that sulfhydryl oxidation was not responsible for the altered flux in ghosts. Treatment with N-ethylmaleimide (NEM) either before or after ghost preparation did not increase Cl-dependent K influx. However, Cl-dependent influx in ghosts could be augmented by increasing ghost volume or ATP content. Resealed human erythrocyte ghosts thus exhibit a volume- and ATP-sensitive, Cl-dependent K flux that differs substantially from the putative Na-K-Cl cotransport in intact cells in that it is independent of Na, is relatively resistant to furosemide and bumetanide, and has a low affinity for K.(ABSTRACT TRUNCATED AT 250 WORDS)

Volume-sensitive Cl-dependent K transport in human erythrocytes

Passive K fluxes, measured with 86Rb, were investigated in osmotically swollen human erythrocytes. K influx and efflux increased progressively with increased hypotonicity up to 167 mosmol/kg. No increase in K flux was seen when NO3 or methylSO4 were substituted for Cl. Substitution of choline or N-methylglucamine for external Na reduced the K flux in swollen cells by only 22%, compared with a 60% reduction in euvolumic cells. However, the magnitude of this Na-dependent component was slightly, but significantly, higher in swollen cells. The presence of Na-dependent K influx in swollen cells was confirmed by measurements of Na influx demonstrating a K-dependent Na influx of similar magnitude in isovolumic and swollen cells. The volume-sensitive K flux was inhibited by bumetanide, but significantly less so than was Cl-dependent flux in isovolumic cells (half-maximal inhibition at 1.0 X 10(-4) vs. 5.8 X 10(-7) M). Kinetic analysis revealed that Cl-dependent K influx had a lower affinity for external K in swollen cells than in euvolumic cells (Km was 29.8 vs. 6.1 mM). The increased K flux in swollen cells was found to be transient, decreasing substantially and reverting back to a predominantly Na-dependent and more bumetanide-sensitive form after 2 h. The results indicate that swelling of human erythrocytes activates a transient Cl-dependent K flux that differs significantly from that in isovolumic cells in that it is less Na dependent, less sensitive to bumetanide, and has a lower affinity for K. Na-K cotransport is either unaffected or slightly increased in swollen cells. The altered flux in swollen cells would thermodynamically favor a volume-regulatory KCl efflux.

The role of pump number and intracellular sodium and potassium in determining Na,K pump activity in human erythrocytes

The factors that determine the activity of the Na,K pump in vivo were investigated by measuring Na,K pump activity under in vivo conditions in human red cells and relating it to the intracellular content of sodium ([Na]i) and potassium ([K]i) and the number of pump units per cell (pump number). Na,K pump activity was measured as ouabain-sensitive K+ influx, pump number was determined from the maximal binding of 3H-ouabain to intact cells, and [Na]i and [K]i were measured by atomic absorption spectrophotometry in washed, packed cells. In the 81 samples studied, pump activity per cell was significantly correlated with pump number (r = .64, P less than 0.001), but was negatively correlated with [Na]i (r = -.28, P less than 0.02) and was not correlated with [K]i. An inverse relationship was found between pump number and [Na]i. When pump activity was expressed as activity per pump unit, rather than per cell, a significant relationship was seen between pump activity and [Na]i (r = .50, P less than 0.001), and a negative correlation existed between the activity per pump unit and [K]i (r = -.29, P less than 0.01). The effect of intracellular Na+ at physiologic levels on pump activity was not strong, with the activity per pump unit increasing only 25% with a doubling of [Na]i. These results indicate that pump number is the major determinant of pump activity in human red cells in vivo, while [Na]i and [K]i are of secondary importance.(ABSTRACT TRUNCATED AT 250 WORDS)

Furosemide-sensitive Na+ and K+ transport and human erythrocyte volume

The relationship between cation transport and cell volume in human erythrocytes was investigated by measuring ouabain-sensitive K+ influx, ouabain-resistant, furosemide-sensitive K+ influx, and ouabain + furosemide-resistant K+ influx, and maximal ouabain binding in microcytic, normocytic and macrocytic red cells. A significant correlation was found between the mean corpuscular volume and furosemide-sensitive K+ influx normalized either to cell number (r = 0.636, P less than 0.001) or to cell volume (r = 0.488, P less than 0.001). No relationship was seen between mean corpuscular volume and ouabain-sensitive K+ influx, and the number of ouabain-binding sites per cell was only weakly correlated with mean corpuscular volume (r = 0.337, P less than 0.05). A slight, negative relationship existed between mean corpuscular volume and ouabain + furosemide-resistant K+ influx expressed per volume of cells (r = -0.359, P less than 0.01), and an apparent relationship between furosemide-sensitive K+ influx and mean corpuscular hemoglobin concentration (r = 0.446, P less than 0.01) disappeared when microcytic samples were excluded from analysis. Furosemide-sensitive transport, including Na+ influx and K+ and Na+ efflux, was completely absent in microcytic cells from one patient with alpha-thalassemia minor. In addition, these cells exhibited a furosemide-resistant, Cl(-)-dependent K+ influx. Exposure of normal erythrocytes to hypotonic conditions (196 mosM) increased furosemide-sensitive K+ influx by a mean of 45% (P less than 0.05), while exposure to hypertonic conditions (386 mosM) had no significant effect. The results indicate that furosemide-sensitive transport and cell volume are interrelated in human erythrocytes. However, the inability to fully recreate this relationship with in vitro manipulation of cell volume suggest that this relationship is established prior to red cell maturation.

Accelerated bone formation causing profound hypocalcemia in acute leukemia

A patient with acute monocytic leukemia and fibrosis presented with severe hypocalcemia producing tetany, myocardial failure, and ventricular tachycardia with torsades de pointes configuration. Hypophosphatemia, hypomagnesemia, an elevated alkaline phosphatase level, and osteosclerosis were also present. Bone marrow biopsy samples showed fibrosis and thickened bony trabeculae lined with large osteoblasts. Tetracycline labeling showed an increased rate of calcification. Complete remission of the leukemia and fibrosis was achieved with a single 3-week course of low-dose cytarabine and hydroxyurea, with resolution of the hypocalcemia and hypophosphatemia. Calcitriol and etidronate disodium were also administered. The calculated left ventricular ejection fraction increased from 15% to 55% with correction of the hypocalcemia. The hypocalcemia and hypophosphatemia in this patient probably resulted from accelerated bone formation stimulated by the leukemic cells. The high dose of calcitriol that this patient received may have contributed to the remission of the leukemia.

Evidence for the role of phospholipids in follicle-stimulating hormone binding to membrane-bound and soluble receptors from calf testis

The role of phospholipids in the interaction of FSH with receptors in the calf testis was explored by studying the effects of phospholipase-C (PL-C) on the binding of radioiodinated human FSH ([125I]iodo-hFSH) to three previously characterized but different preparations of FSH receptor: a membrane fraction derived from calf testis homogenate, a buffer-soluble receptor present in the cytosol of the calf testis homogenate, and a detergent-soluble receptor prepared from the membrane fraction by extraction with Triton X-100. Prior incubation with PL-C markedly reduced specific [125I]iodo-hFSH binding to the membrane-bound and buffer-soluble receptors. This loss in binding was associated with hydrolysis of phospholipids, was prevented by the addition of o-phenanthroline, an inhibitor of PL-C, but not by the addition of a protease inhibitor, and could not be reproduced by the addition of the products of PL-C hydrolysis. Enzyme treatment did not dissociate [125I]iodo-hFSH already bound to the buffer-soluble receptor and dissociated only 20% of [125I]iodo-hFSH bound to membrane receptor. PL-C treatment did not reduce [125I]iodo-hFSH binding to detergent-solubilized receptor, nor did it hydrolyze constituent phospholipids. The apparent resistance of the detergent-solubilized receptor to PL-C treatment was studied by incubating membranes with or without PL-C before detergent solubilization. Triton X-100 itself (2%) inhibited phospholipid hydrolysis by PL-C, but this could be overcome by reducing the detergent concentration 10-fold by dilution. Despite a marked decrease in specific [125I]iodo-hFSH binding to PL-C-treated membranes compared to that of untreated controls, the total amount of [125I]iodo-hFSH binding to Triton X-100 extracts of each membrane preparations was not significantly different. Addition of Triton X-100 to the buffer-soluble receptor restored 40% of the hormone binding that had initially been lost concomitant with enzymic hydrolysis of membrane phospholipids. It appears that constituent phospholipids play an important role in the interaction of FSH with membrane-bound or solubilized receptor and that Triton X-100 is able to substitute, although imperfectly, for phospholipids in that regard, probably because of its related amphipathic properties.

Biochemical properties of the testicular follitropin-receptor system

The interaction of FSH with membrane receptors from rat and calf testis has been studied in some detail. The FSH receptor has been solubilized through use of the nonionic detergent Triton X-100 and highly purified by affinity chromatography on Affigel-10 coupled to ovine FSH. Hormone binding activity of the solubilized receptor has been preserved for extended periods through use of the structure-stabilizing agent glycerol. Other components of the FSH testes receptor system including the guanyl nucleotide binding protein and adenylate cyclase have been solubilized by nonionic detergents and also found to be stabilized by glycerol. FSH binding activity has been observed in testes cytosol and represents a putative class of receptors prepared from testes in the absence of detergent. The concentration of this buffer-soluble component decreased with age and increased concomitantly with loss of membrane receptors consequent to their down-regulation after administration of exogenous FSH. Phospholipids seem involved in the interaction of FSH with membrane-bound, detergent-solubilized, and buffer-soluble FSH binding activity. Phospholipids may maintain or stabilize a particular receptor conformation necessary for interaction with the hormone. A specific role for GTP seems indicated in regulation of FSH-stimulated adenylate cyclase activity in immature rat testis. Follitropin binding to testes receptor appears modulated by a variety of factors present in serum, testes extracts, follicular fluid, and seminal plasma, which are poorly understood at present. Inhibition of FSH binding by seminal plasma best-fit by a model proposing two hormone binding sites per receptor molecule, where binding to one site decreases the affinity of the other site for FSH. As a result of studies in this and other laboratories, the molecular endocrinology of FSH interaction with testis receptors is becoming increasingly understood.

Isolation and partial characterization of an acetylcholine receptor-enriched membrane fraction from skeletal muscle

A procedure for purification of the bungarotoxin-binding fraction of sarcolemma from rabbit skeletal muscle is described. Muscle is homogenized in 0.25M sucrose without high salt extraction and membrane fractions separated initially by differential centrifugation procedures. An ultracentrifugation pellet enriched in cell surface and sarcoplasmic reticulum markers is further fractionated on a dextran gradient (density = 1.0 to 1.09). Two fractions are identified as sarcolemma according to high specific activities for lactoperoxidase-iodination, Na+, K+-ATPase and alpha-bungarotoxin-binding. No Ca++, Mg++-ATPase activity is found in these fractions. A third fraction, the dextran gradient pellet, is enriched in Ca++, Mg++-ATPase activity and lactoperoxidase iodinatable material and characterized by low bungarotoxin binding. This fraction represents a mixture of sarcoplasmic reticulum and transverse tubules with some sarcolemma contamination.